Housemanship delay solution in sight, experts say

THE perennial problem of medical graduates having to wait for months for their housemanship was made worse by the Covid-19 pandemic which resulted in the suspension of recruitment of new housemen.

In a bid to address the issue, the government, through the Higher Education Ministry, has applied for an extension on the 2011 moratorium on offering new medical courses in higher education institutions until 2026, Health Minister Datuk Seri Dr Adham Baba told Parliament on Sept 15.

The original moratorium would have ended next year.

Seniors in the medical field, however, are optimistic that there is a solution to the issue that has long plagued Malaysia’s aspiring doctors.

Malaysian Medical Association (MMA) president Prof Datuk Dr Subramaniam Muniandy (pic left) called on the government to conduct a review of varsities that offer medical courses.

This will ensure the quality of graduates and prevent an oversupply of doctors.

University hospitals, he added, should all be allowed to train medical graduates.

He also suggested gazetting new training centres for housemen.

“We are pushing for extended contracts so doctors can become specialists in different fields.

“With enough specialists posted to district hospitals, more centres can be gazetted as housemanship training centres, ” he told StarEdu.

While the government through various ministries is seriously looking into the issues, it is unrealistic to expect a promise of permanent positions, he said.

“Last year, critical allowances were reinstated and for now, extended contracts are being studied.

“We hope that with constant engagement, there will be a favourable solution for our junior doctors.

“The current waiting period is nine months because of Covid-19. It was previously six, ” he said, adding that the wait has gotten shorter over the years. There was a time when graduates had to wait almost a year before they got their postings.

The MMA, said Dr Subramaniam, is doing its part by providing short-term training such as the “ABCs of Housemanship”, to sharpen graduates’ clinical skills during their waiting period.

Former MMA and the Medico-Legal Society of Malaysia president Datuk Dr N.K.S. Tharmaseelan proposed making it mandatory for the country’s private medical colleges to have their own hospitals for the training of housemen instead of leaving it to a limited number of government hospitals to do the job.

“Most established medical colleges would have no problem building hospitals as it can also cater to the healthcare needs of Malaysians.

“With a well-thought out plan, this could be an effective way to resolve the perennial housemanship problem, ” he said, noting that Malaysia is one of the few countries where it is not mandatory for medical colleges to have their own hospitals for training purposes.

And if more specialists are posted to district hospitals, these hospitals can be transformed into training centres for house officers, Dr Tharmaseelan, who is also a professor of obstetrics and gynecology at Melaka-Manipal Medical College, said.

The ministry, he opined, should look into improving the deployment of trained staff, facilities and specialists to enable new and upgraded hospitals to function and be gazetted as training centres for medical graduates as housemen.

He also called for a common qualifying exam for foreign medical graduates to level the playing field and assure the quality of medical graduates being employed.

Elaborating on the common qualifying exam, Universiti Putra Malaysia Faculty of Medicine and Health Sciences dean Prof Dr Zamberi Sekawi said it is currently in the proposal stage.

Describing it as a common licensing exam, Prof Zamberi said only graduates who sit for it and pass are eligible for housemanship.

“Many countries, except for Malaysia, already have this in place.

“Those who are well-trained and competent will easily pass and complete their training on time.

“It may not be a foolproof method of tackling the issue, but it is one way to shorten the waiting time for medical graduates and to ensure their quality, ” he said.

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah urged the government to put a cap on the number of medical colleges in the country.

“Slow down the churn. Focus on producing quality medical graduates instead.

“Hardworking and high performing housemen should be allowed to complete their housemanship earlier so that they can proceed to do their specialisation.”

The Public Services Department, he said, should allocate more posts for housemen and absorb the deserving ones as permanent medical officers.

“A less spoken about, but equally important aspect, is educating parents to stop forcing their children to study medicine if they are not interested, ” he said.

Doctors, do your part

BEING left in limbo for almost a year while waiting for a housemanship posting can be frustrating but medical graduates can do their part by picking up skills that would prove useful during their housemanship.

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah, Universiti Kebangsaan Malaysia Faculty of Medicine former dean and Obstetrician and Gynecologist senior consultant Prof Dr Zaleha Abdullah Mahdy and Universiti Putra Malaysia Faculty of Medicine and Health Sciences dean Prof Dr Zamberi Sekawi suggest ways aspiring doctors can sharpen their skills while waiting for housemanship offers:

Work in the health sector. It is good to be exposed to a real working environment but make sure that you are supervised. Be mindful of the laws and ethics.

Assist doctors to do clinical research in universities, or tag along with doctors in hospitals/clinics. This is so you will not forget the skills learnt in medical school.

Take up short courses and professional certificates.

Do voluntary work or short-term jobs with non-governmental organisations. You will gain empathy and communication skills.

Attend housemanship preparatory courses.

Do an attachment with private clinics. It gives you entrepreneurial skills and a perspective on the challenges of running a clinic.

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